FUE (Folicular Unit Extraction) technique was first described by the Australian doctor Ray Wood in 1995. In 2002, Dr. Bernstein presented FUE technique that is hair grafts are taken one by one with an article. As in the FUT technique, the scalp is not cut with a surgical scalpel and donor area is not sutured which means that no long and prominent scars are left on the patient’s scalp. In FUE technique, a small circular skin incision of 0.5-0.9 mm diameter is made by using “punch” (tube-shaped instruments with one sharp end), and the hair follicles are extracted one by one. So technique is renamed as Follicular Unit Excision technique by combining the words “extraction” and “incision”. Although it is understood that FUT and FUE methods differ mainly in terms of the method of removing hair follicles, the results of the two operations are also different because of harvested graft number is almost always high in FUE technique .
When we used FUE technique for the first time, people who did not care about the scars on the neck caused by previous FUT operations and did not refuse to cut their hair short were preferred. However, when the method was developed later, the number of hair follicles that could be harvested with FUE operations doubled to three times the number that could be harvested with the FUT method. Both thinner and single grafts were obtained, as very thin punches were used to harvest the grafts and results become more natural. The only disadvantage in the FUE method is that the entire donor area of the patient (scalp, beard or chest areas) must be shaved short (number 1) in order to extract the hair follicles and harvesting duration is longer than FUT.
Except for people whose social and business life may be adversely affected by shaving their hair, the FUT method is not used anymore. Since more grafts can be taken, more natural hair transplantation is possible with the FUE method. In the past, our patients who used the FUT method used to have numbness at the incision site within 6-12 months after surgery. The reasons behind this were nerve injury and long healing process of the nerve tissue. In the FUE method, we do not observe these complications and the patients have a painless and comfortable time with very less or no edema/swelling or bruising after the operation.
In the FUT method, some hair follicles may be damaged and the number of healthy grafts may decrease during the stage of graft preparation on the table by cutting scalp in to small pieces and follicular units. In the FUE method, this problem may also ocur while grafts are being harvested with small sharp punches. However, because the grafts taken with the FUE method are thinner and contain less epithelium, survival of the grafts is higher.
The recovery time in the FUE technique is much shorter than in the FUT technique. Because the very small holes formed in the skin in the FUT technique will reepithelised and close in a few days, while the complete healing of a large incision in the FUT technique is a longer process. The tension in the neck after the FUT technique can force the patient’s daily head movements and cause discomfort, pain and dehiscence of wound. However, those are not problems in FUE technique.